RE: Need for medical advice

May 17, 2012

Of course there is no moral controversy here -- the Church's teaching is very clear here that sterilization is not permitted -- but the cardiac-medical dilemma is complex. She certainly is at a higher risk from another pregnancy all other things being equal and probably ought not to conceive again, but there are higher and lower risk groups within that group, and it certainly is not true that another pregnancy would automatically be a death sentence. SHe needs to see a cardiologist familiar with this syndrome, get a really good risk assessment, and even more importantly, while it would likely be prudent to avoid another pregnancy, to have a good management plan should one happen, because such a plan is potentially life-saving for both mom and baby should another pregnancy develop. This heart management issue, and that of how to licitly avoid another pregnancy, is what they should be concentrating their efforts on, instead of this waste of time hand-wringing over a supposed "dilemma of conscience" which for conscientious Catholics really isn't a controversy at all. This couple will be more likely to succeed in this difficult situation once they have the inner peace of a conscience unshakably convinced and resolute to obey the moral law.

We can't deliberately choose sin regardless so f the consequences.

Cardiology and OB/GYN intensive help is needed, should another pregnancy occur, but this ought to be avoided. IF long-term abstinence is needed to provide the necessary certainty (hopefully not but at times it can be) then so be it. This is not intended to be a pastoral response to the issue, just a response among us providers. For the couple of course great sensitivity is needed on the part of whoever helps them.

Sincerely yours,

Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

Interventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning Researcher

Medical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com)

405-947-2228 (office)

405-834-7506 (cell)

405-947-2307 (FAX)

pedullad@...

"...the priestly ministry is not just a pastoral service; it ensures the continuity of the functions entrusted by Christ to the Apostles and the continuity of the powers related to those functions. Adaptation to civilizations and times therefore cannot abolish, on essential points, the sacramental reference to constitutive events of Christianity and to Christ himself." (Inter Insignores)

Need for medical advice

CG recently contacted me seeking advice for dealing with her PCOS, hypertension and cardiac issues; NFP use; and the morality of sterilization under the circumstances, etc.

I think I handled the NFP and sterilization aspects, but I can't do the medical.

Her family recently moved to the Dallas area, so I referred her to:

ph P Behan MD Specialty: OB-GYN Phone: (214) 692-8660 NFP Model: BOM Dallas, TX 75231 USA and

A Kalamarides DO Specialty: OB/GYN Phone: (512) 458-6060 NFP Model: CrM Austin, TX 78731

What advice can I pass on to her? Or, does someone want to communicate with her directly?

Thanks and blessings.

Steve Koob

800-307-7685

> > My husband and I are in need of additional guidance. We recently had our first baby boy. My medical history is that I have had a stroke in the past, and was also diagnosed with pregnancy induced hype

rtension. I was in the hospital for three weeks, before I had to deliver our baby via csection. A few days after delivery, the doctors sent me home, thinking that all was normal. However, I went into heart failure at home, and had to return to the cardiac unit, where I was admitted for another week of monitoring. I was finally diagnosed with postpartum cardiomyopathy, and was told by my cardiologist that if I were to get pregnant again, it would be doubly fatal to me and my future potential baby. My husband and I are feeling lost on our action from here. We have spoken with a number of people, and now have opposing views from one another. Our parish priest had a long conversation with my husband, stating that especially out of pastoral concern, there would be nothing sinful in trying to prevent pregnancy through a vasectomy, as I have an obligation to take care of my current family. I have only been able to do minimal research on this, but am curious if he was referring to t

he responsibility discussed in paragraph 10 of Humanae Vitae? My parents know what we are struggling with, and my mom has also discussed our situation with a number of priests, who have also given her the same answer: it would not be sinful for my husband to have the surgery. However, when I contacted The National Catholic Bioethics Center, they told me that all the priests we have spoken with were mis-catechized and teaching us incorrectly. Our NFP instructors at Church also said any type of surgery would be wrong, and that maybe God is calling me to lay down my life if I were to get pregnant again and pass away. I am so confused, and we are in need of help on who we should listen to. We have been praying about our questions, but we also have not been able to devote the needed time into really reaching out for resources to help us. The Bioethics Center also said that the Church teaches that a vasectomy would be wrong now in our situation, but this could change in the future...Which only confused me even more. We want to be faithful to our Lord's Will, but we are getting conflicting information. I've also read that maybe we should abstain until I can no longer conceive, but this seems contrary to the married life. As I understand, having relations with your spouse is not only for procreative pursposes, but unitive. It seems that if I have a life or death situation to prevent pregnancy, that I would be justified in not "walking out in the road, in the middle of traffic" to put it plainly, and the Lord gave us the blessing and knowledge for doctors who have developed medicine for curative purposes. We practiced NFP before pregnancy, and of course understood prior to our current situation that preventing pregnancy via vasectomy would have been wrong according to our Faith. We have an additional complication, in that I have PCOS, which makes it difficult to predict my cycles. This made NFP difficult before, but now with my heart condition, ma

kes the prospects of getting pregnant very scary. Can you offer us any additional assistance? Thank you so much for your time in helping us with this very difficult and sensitive decision in our lives.

Sincerely, CG

May 17, 2012

In the DFW area there is also

Dr. Don D. Palencia, DO

Lake Arlington Family Medicine

2309 W. Green Oaks Blvd

Arlington, TX 76016

817-496-4957

CrM

Sincerely,

Reisinger

Dallas Couple to Couple League

(972) 275-NFP1

On 2:51:17 pm 05/17/12 Dominic <pedullad@...> wrote:

> Of course there is no moral controversy here -- the Church's teaching

> is very clear here that sterilization is not permitted -- but the

> cardiac-medical dilemma is complex. She certainly is at a higher risk

> from another pregnancy all other things being equal and probably ought

> not to conceive again, but there are higher and lower risk groups

> within that group, and it certainly is not true that another pregnancy

> would automatically be a death sentence. SHe needs to see a

> cardiologist familiar with this syndrome, get a really good risk

> assessment, and even more importantly, while it would likely be prudent

> to avoid another pregnancy, to have a good management plan should one

> happen, because such a plan is potentially life-saving for both mom and

> baby should another pregnancy develop. This heart management issue, and

> that of how to licitly avoid another pregnancy, is what they should be

> concentrating their efforts on, instead of this waste of time

> hand-wringing over a supposed " dilemma of conscience " which for

> conscientious Catholics really isn't a controversy at all. This couple

> will be more likely to succeed in this difficult situation once they

> have the inner peace of a conscience unshakably convinced and resolute

> to obey the moral law.

>

> We can't deliberately choose sin regardless so f the consequences.

>

> Cardiology and OB/GYN intensive help is needed, should another

> pregnancy occur, but this ought to be avoided. IF long-term abstinence

> is needed to provide the necessary certainty (hopefully not but at

> times it can be) then so be it. This is not intended to be a pastoral

> response to the issue, just a response among us providers. For the

> couple of course great sensitivity is needed on the part of whoever

> helps them.

>

> Sincerely yours,

>

> Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

> Interventional Cardiologist, Endovascular Diplomate, Varicose Vein

> Specialist, Noncontraceptive Family Planning Consultant, Family

> Planning Researcher Medical Director, The Oklahoma Vein and

> Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundat

> ion.com)

> 405-947-2228 (office)

> 405-834-7506 (cell)

> 405-947-2307 (FAX)

> pedullad@...

>

> " ...the priestly ministry is not just a pastoral service; it ensures

> the continuity of the functions entrusted by Christ to the Apostles and

> the continuity of the powers related to those functions. Adaptation to

> civilizations and times therefore cannot abolish, on essential points,

> the sacramental reference to constitutive events of Christianity and to

> Christ himself. " (Inter Insignores)

>

> Need for medical advice

>

> CG recently contacted me seeking advice for dealing with her PCOS,

> hypertension and cardiac issues; NFP use; and the morality of

> sterilization under the circumstances, etc.

> I think I handled the NFP and sterilization aspects, but I can't do

> the medical.

> Her family recently moved to the Dallas area, so I referred her to:

> ph P Behan MD Specialty: OB-GYN Phone: (214) 692-8660 NFP

> Model: BOM Dallas, TX 75231 USA and A Kalamarides DO

> Specialty: OB/GYN Phone: (512) 458-6060 NFP Model: CrM Austin, TX

> 78731 What advice can I pass on to her? Or, does someone want to

> communicate with her directly?

> Thanks and blessings.

>

> Steve Koob

> 800-307-7685

>

> > > My husband and I are in need of additional guidance. We recently

> > > had our first baby boy. My medical history is that I have had a stroke

> > > in the past, and was also diagnosed with pregnancy induced hype

> > > rtension. I was in the hospital for three weeks, before I had to

> > > deliver our baby via csection. A few days after delivery, the doctors

> > > sent me home, thinking that all was normal. However, I went into heart

> > > failure at home, and had to return to the cardiac unit, where I was

> > > admitted for another week of monitoring. I was finally diagnosed with

> > > postpartum cardiomyopathy, and was told by my cardiologist that if I

> > > were to get pregnant again, it would be doubly fatal to me and my

> > > future potential baby. My husband and I are feeling lost on our action

> > > from here. We have spoken with a number of people, and now have

> > > opposing views from one another. Our parish priest had a long

> > > conversation with my husband, stating that especially out of pastoral

> > > concern, there would be nothing sinful in trying to prevent pregnancy

> > > through a vasectomy, as I have an obligation to take care of my current

> > > family. I have only been able to do minimal research on this, but am

> > > curious if he was referring to t he responsibility discussed in

> > > paragraph 10 of Humanae Vitae? My parents know what we are struggling

> > > with, and my mom has also discussed our situation with a number of

> > > priests, who have also given her the same answer: it would not be

> > > sinful for my husband to have the surgery. However, when I contacted

> > > The National Catholic Bioethics Center, they told me that all the

> > > priests we have spoken with were mis-catechized and teaching us

> > > incorrectly. Our NFP instructors at Church also said any type of

> > > surgery would be wrong, and that maybe God is calling me to lay down my

> > > life if I were to get pregnant again and pass away. I am so confused,

> > > and we are in need of help on who we should listen to. We have been

> > > praying about our questions, but we also have not been able to devote

> > > the needed time into really reaching out for resources to help us. The

> > > Bioethics Center also said that the Church teaches that a vasectomy

> > > would be wrong now in our situation, but this could change in the

> > > future...Which only confused me even more. We want to be faithful to

> > > our Lord's Will, but we are getting conflicting information. I've also

> > > read that maybe we should abstain until I can no longer conceive, but

> > > this seems contrary to the married life. As I understand, having

> > > relations with your spouse is not only for procreative pursposes, but

> > > unitive. It seems that if I have a life or death situation to prevent

> > > pregnancy, that I would be justified in not " walking out in the road,

> > > in the middle of traffic " to put it plainly, and the Lord gave us the

> > > blessing and knowledge for doctors who have developed medicine for

> > > curative purposes. We practiced NFP before pregnancy, and of course

> > > understood prior to our current situation that preventing pregnancy via

> > > vasectomy would have been wrong according to our Faith. We have an

> > > additional complication, in that I have PCOS, which makes it difficult

> > > to predict my cycles. This made NFP difficult before, but now with my

> > > heart condition, ma kes the prospects of getting pregnant very scary.

> > > Can you offer us any additional assistance? Thank you so much for your

> > > time in helping us with this very difficult and sensitive decision in

> our lives.

> Sincerely, CG

>

May 17, 2012

The problem is in the heart. An operation on a different patient will not benefit the cardiac patient's heart. In one case of which i was aware, patient had dilated cardiomyopathy at delivery.Subsequently preparations were made for heart transplantation.before it could be done, the condition resolved spontaneously. No method of family planing works 100%, not even vasectomy.One could make NFP more effective, by restricting intercourse to times more certain to be infertileif cycles irregular, usually could overcome that by working with teacher I think you should make a back-up plan in case pregnancy does occur.if a viable plan was in place, it would ease fears and place patient one step ahead if it did occurIf the lady has a significant heart problem, it would be best to deal with it before she gets pregnantIf that was done, it would help her more than a vasectomy There could be nutritional approaches to optimizing cardiac functionThis should be done with medical supervision, not do it yourself they should be done in addition to cardiologic approaches, not in place ofwhile i am not a cardiologist, i have done the nutritional approaches with success i think if ob and cardiology work togetherthey can pool their skills successfullyrather than multiplying their fears From: nfp@...Date: Thu, 17 May 2012 15:30:04 +0100Subject: Re: Need for medical advice